Director, Revenue Integrity Edits, & Charge Capture Operations

University of Washington Medical Center•Seattle, WA

2d•Onsite

About The Position

UW Medicine’s Revenue Integrity Department has an outstanding opportunity for a Director of Revenue Integrity Edits, & Charge Capture Operations. UW Medicine Enterprise Revenue Cycle (ERC) is accountable for Revenue Cycle functions at UWMC ML, UWMC NW, HMC, and close collaboration with FPPS. UW Medicine ERC Revenue Integrity (RI) develops and coordinates operations and programs that oversee a wide range of revenue capture and integrity areas.

Requirements

Bachelor’s Degree (BA or BS) in business, finance, healthcare, or a related field
10+ years of related leadership experience in a complex academic, research, healthcare or governmental setting, revenue cycle management/revenue integrity, or an equivalent combination of education and work experience
Coding credentials CCS, COC, RHIT or RHIA from AAPC, or AHIMA – if not credentialed, must be credentialed within one year of hire date
Understanding of hospital billing or reimbursement and charge capture operations
Excellent project management, problem solving, and analytical skills
Demonstrated proficiency standard Project Management principles and tools
Demonstrated working knowledge of considerations and processes surrounding Revenue Cycle Operations in a healthcare environment, including both hospital and physician settings
Understanding of CMS and Medicaid regulations and ability to interpret healthcare guidelines and regulations
Proficiency with financial, billing and reimbursement data & analytics
Excellent communication and interpersonal skills, both verbally and in writing, with employees, medical staff, board members, and external parties; strong presentation skills
Detail-oriented and independently motivated
Demonstrates knowledge and proficiency of standard Microsoft Suite including Teams, Word, Excel, Visio, Outlook, and Power Point
Experience with large EHR implementation projects or hospital integration projects

Nice To Haves

Advanced degree in business, finance, or a healthcare related field
Familiarity with multiple Epic systems modules
Continuous Quality Improvement training and experience leading quality improvement teams
A skilled communicator with an ability to create a collaborative work environment with multiple stakeholders across non-co-located entities is highly preferred.
Experience with the hospital financial system, the A/R system, hospital ancillary systems (e.g., Radiology, Laboratory) and the data within such systems

Responsibilities

Lead and support enterprise-wide revenue integrity and charge capture initiatives to improve financial performance and compliance
Serve as a management-level representative on Finance, Ambulatory Care Division, and Compliance committees
Partner with medical, nursing, ambulatory, compliance, and revenue cycle leadership to identify process gaps, redesign workflows, and resolve charge capture issues
Maintain strong, service-oriented relationships with executive sponsors, stakeholders, and project teams, providing regular status updates and reporting
Oversee facility and professional charge capture processes across 376 service lines, including reconciliation of charges from Epic/EpicCare
Monitor revenue, utilization, Epic workflows, and charging data to identify trends, risks, and improvement opportunities
Analyze missing charges, late charges, denials, write-offs, and code/charge discrepancies; recommend and implement corrective actions
Ensure compliance with federal and state billing regulations and coding guidelines
Direct operational changes as needed to achieve compliant and accurate charge capture
Provide leadership for the design, implementation, and maintenance of ordering and charging tools.
Identify opportunities for automation and system optimization within Epic, EpicCare, and related reporting tools
Research and resolve issues within Epic work queues (Charge Review, Charge Router, Revenue Guardian, Error Pool)
Recommend and enhance reporting (BOE/SSRS) to support leading practice revenue cycle performance monitoring
Provide direct managerial and administrative oversight of Revenue Integrity staff, including mentoring, performance management, and goal setting
Lead weekly Revenue Integrity meetings to review regulatory updates, assign work, and track follow-up actions